Patients with chest pain suffer from inadequate blood supply to the heart. This "myocardial ischemia" is reflected in changes in many physiologic parameters, including coronary flow reserve and myocardial contractile reserve. Perfusion imaging and stress-induced wall motion are the most commonly used clinical tests for ischemia assessment. Unfortunately these current clinical standards are known to have significant inaccuracy due to fundamental issues of image resolution and image quality. Improving the clinical assessment of myocardial ischemia will be enormously important since there are more than 3 million studies are conducted each year. Magnetic resonance imaging is potentially able to overcome all the known technical difficulties associated with the current techniques. While raw image acquisition speed has improved significantly, the goal of assessing myocardial contraction and perfusion volumetrically during an induced 60-90 second time window of true ischemia is far from being realized. This is primarily limited by inadequate imaging speed. It is also hindered by the inability to adjust, in real-time, the scan volume during the course of the study. In this proposal, we will develop an integrated examination of cardiac ischemia that will allow for real-time interactive evaluation of myocardial contraction and perfusion at 24 true frames/second/slice over at least 3 slices. It is expected that this research will have a significant impact on the accuracy of clinical ischemia assessment.